Table 3.
Cross-sectional studies performed in patients with obesity and depression
| Author (year) | Participants | Objectives | Results | Quality of the study |
|---|---|---|---|---|
| Kinley et al. [21] (2015) | N=4.181 | To examine the association between cardiac and metabolic conditions including obesity, anxiety and depression | Among depressed individuals (N=699) 130 were obese (16.9%). It calculated the OR of obesity for people with depression adjusted to various confounding factors obtaining an OR of 0.85 (95% CI, 0.66 to 1.09) It concluded that depression was not associated either with cardiac or metabolic conditions, but rather with the deterioration of self-care which had an impact on these health problems | Low |
| Ages from 18 to 65 | ||||
| Ul-Haq et al. [30] (2014) | N=140.564 | To examine the probable relationship between major depression and various measurements of adiposity (BMI, waist circumference, waist-hip index and percentage of body fat) | The OR adjusted for obese participants was of 1.16 (1.12–1.20) using the BMI; 1.15 (1.11–1.19) applying the waist circumference and 1.18 (1.12–1.25) when applying the waist-hip index | Low |
| Ages from to 40 to 69 (average age of 57) | There was a significant association between adiposity and gender. Overweight women were at an increased risk of depression with a dose-response effect. However, in men, there was only a significant risk of depression for those with obesity type III | |||
| Adiposity has been associated with probable major depression, regardless of the used measurements. The association is stronger in women than in men | ||||
| Rottenberg et al. [19] (2014) | N=210 people with depression, 195 siblings and 161 healthy controls | To assess whether there is an association between depression and cardiovascular risk factors (including obesity) in adolescents with depression which started during their childhood. To do this, he compares them with adolescent siblings of depressed patients (without depression) and with healthy controls | Major depression in childhood is associated with an unfavourable profile for cardiovascular risk factors. For overweight patients the OR (depressed/controls) was 2.13 (1.0–4.56) and for obese patients the OR (depressed/controls) was 3.67 (1.42–9.52) | Low |
| The average age was of 17 in the first group 15.9 in the second one and 15.8 in the third one | ||||
| 63.3% were men | ||||
| Yu et al. [18] (2014) | N=4,511 (1,382 men and 3,129 women). Ages varied between 35 and 69 (average age 53). BMI was measured and the questionnaire PHQ-9 was passed, based on DSM-IV criteria. They considered major depression if the score was equal to or greater than 10 | To investigate the association between depressive symptoms and diet quality, physical activity and body composition | Compared with healthy individuals, those with mild and major depression have significantly higher ORs for obesity (BMI) and abdominal obesity. Thus, the OR of obesity (BMI>30) in major depression is 1.56 with a 95% CI of (1.30–1.87) and for abdominal obesity the OR is 1.88 with a 95% CI of (1.58–2.24) | Low |
| Vannucchi et al. [23] (2014) | Multicenter | To investigate the relationship between obesity and the history of manic or hypomanic symptoms in a sample of patients with major depression | Obese patients belonged more frequently to the bipolar group than non-obese patients. They reported more often an HCL scale of over 14. There were 27 people with bipolar disease in the obese patient group (31.4%) and 92 people in the non-obese group (19.0%). There were significant differences between both groups. In addition, the difference was greater in favour of patients with a BMI of over 35. The more obese a patient was the higher risk he had of suffering from bipolar disorder. Obesity in this sample of patients with a major depressive episode is associated with bipolar disorder | Low |
| N=571 | ||||
| Ages vary from 18 to 75 | ||||
| Roberts and Duong [12] (2013) | N=4,175 adolescents with ages between 11 and 17. The population sample is taken from adolescents living in Houston homes, only 66% of them took part in this study. BMI is measured as well as, depression according to Diagnostic Schedule of Interviews for Children and Adolescents (DSM-IV), weight perception and body satisfaction | To examine the association between major depression, obesity and body image among adolescents | Obesity was associated with an increased risk of depression OR=2.51, 95% CI (1.47–4.29) | Low |
| However, when the association was examined in models that included weight, major depression and body image and covariates, there was no significant association between major depression and weight, or between body satisfaction and major depression. The real significant association was the relationship with perceived weight and depression | ||||
| Thus, even with normal weight, the OR for major depression was greater when the perceived weight was higher | ||||
| Chou and Yu [15] (2013) | N=10,557 adults over 70 years of age | To reveal the conclusion in the obesity rate associated with classic, atypical and undifferentiated depression compared with those subjects without depression in a representative sample of the population in the USA | It was revealed that after adjusting for sex, age, marital status, race and personal income, the obesity rate was significantly higher for those who had atypical depression than for the rest of the subtypes including controls. The same results were concluded for people that had already passed depression, with current depression and depression throughout their life | Low |
| OR (obesity in atypical depression versus obesity control): Lifetime: 4.03; current: 5.53; past: 3.53, all of them significant | ||||
| It measured obesity according to BMI (BMI>30), major depression based on AUDASDIS-IV score, and criteria of major depression according to DSM-IV | The rest (classic and indifference vs. control) were not significant | |||
| These findings suggest that the heterogeneity of depression should be considered when examining the effect of depression over obesity in the elderly | ||||
| Levitan et al. [17] (2012) | The group identified 5,092 American adults with past or current depression based on the DSM-IV criteria and 1,500 controls matched by gender. They were divided into three subgroups, depending on the subtype of major depression: classic, atypical and undifferentiated. Those who were both classical and undifferentiated were removed (266) | To examine whether the increased risk of obesity is significant for the basic subtypes of major depression or if it is limited to the atypical subtype | Subjects with atypical depression had noticeably elevated rates of obesity compared to controls and other depressed subjects. OR (atypical vs control): 2.61; 95% CI (2.16–3.16). OR (classic vs. atypical): 0.38; 95% CI (0.32–0.45). OR (atypical versus undifferentiated): 2.27 95% CI (1.90–2.71) | Low |
| Only atypical depression is associated with a high risk of obesity | ||||
| Merikangas et al. [13] (2012) | N=4,150 adolescents with ages between 12 and 19 from the USA. 76% of the initial sample (2001–2004). The study measured weight and height (BMI) subjects were considered obese if IMC was over 95% for their age | To study the association between obesity and depression in this sample of adolescents | After adjusting for sex, race or ethnicity, age and poverty, major depression was not significantly associated with obesity among adolescents in general (depressed obesity/non-depressed obesity) OR=1.6; 95% CI (0.9–2.9). However there was a significant increased risk among men suffering from depression [OR=2.7, 95% CI (1.1–7.1)] and among depressed non-Hispanic blacks [OR=3.1 with a 95% CI (1.1 –8.3)] | Low |
OR: odds ratio, CI: confidence interval, BMI: body mass index, RR: relative risk